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Query: UMLS:C0001175 (AIDS)
 120,706 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A normal host can be colonized by mycobacteria other than tuberculosis (MOTT), resulting in bronchoscopic isolates of no clinical significance. In the acquired immunodeficiency syndrome (AIDS), Mycobacterium avium-intracellulare, Mycobacterium kansasii, and Mycobacterium xenopi have caused widely disseminated infection. To determine the usefulness of fiberoptic bronchoscopy (FB) in evaluating MOTT infection in AIDS, we reviewed MOTT cultures from 36 FBs, correlated these to clinical course, and identified MOTT isolates from cultures of all other sources in these patients. Of ten bronchoscopic MOTT isolates, seven were not related to lung disease or to dissemination within one month of FB. Of the four Mycobacterium fortuitum and seven M avium-intracellulare that did disseminate within one month, only two were reflected in bronchoscopic cultures. In patients with AIDS, bronchopulmonary MOTT colonization does occur. We recommend that standard criteria for pulmonary mycobacterial disease be applied. Negative bronchopulmonary cultures do not seem to exclude dissemination.
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PMID:Mycobacteria other than tuberculosis. Pulmonary involvement in patients with acquired immunodeficiency syndrome. 335 12

56 cases of pregnant women with a positive HIV serology were reported in 20 months at the Maternity of the Nice Hospital Center. In 10 cases, there were clinical signs of the disease (9 ARC-Syndrome, one case of AIDS). The predisposing factor was most of the time drug addiction, 53 cases (94.5%) and one case occurred after a blood transfusion. In the majority of the cases (52%) the pregnancy was pursued because of the late term or the patient's decision. A therapeutic abortion was performed in 12 instances (25%) and an interruption before 12 weeks of amenorrhea in 15 cases. 24 women delivered. The obstetrical complications were frequent with especially a fetal death in utero, five premature deliveries and fifteen hypotrophies. A severe infectious complication (septicemia, pneumopathy secondary to Pneumocystis carinii) was observed in 9 cases, a marked thrombopenia causing profuse post-partum haemorrhages in one case. Finally, one woman died 35 days after delivery. The study of the consequences on the child is incomplete because of insufficient follow-up: all children were sero-positive at birth and among thirteen children aged between 12 to 20 months, there were one death, one AIDS syndrome, 4 ARC-syndrome, 4 sero-positive and 3 sero-negative. The notion of HIV sero-positivity in a pregnant woman presents serious problems for the obstetrician. Decompensation of the disease during the pregnancy is uncertain but it is now confirmed that the child is affected, and this is a well established fact. These important consequences lead to propose, at this time a therapeutic interruption of pregnancy when possible, depending on the term, and when accepted by the patient.
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PMID:[Positive HIV (human immunodeficiency virus) serology in the pregnant woman: current data on its management. Apropos of a continuous series of 56 cases]. 347 87

Interleukin 1 secretion from human alveolar macrophages was studied in patients with interstitial pulmonary fibrosis, sarcoidosis, and the acquired immunodeficiency syndrome with pneumonitis and compared to secretion from alveolar macrophages of normal volunteers. Macrophages lavaged from the lungs were stimulated with 10 micrograms/ml of lipopolysaccharide and cultured for 24 hr. In some cases macrophages were also stimulated with 1 microgram/ml lipopolysaccharide. After dialysis of the culture supernatants, interleukin 1 secretion was quantified by the thymocyte proliferation assay and probit analysis and expressed in terms of secretion from 1 million macrophages. Results showed that, on average, macrophages derived from patients secreted more interleukin 1 after stimulation with lipopolysaccharide compared to normal subjects. Mean secretion was significantly greater from macrophages of patients with acquired immunodeficiency syndrome and interstitial pulmonary fibrosis when stimulated with 10 micrograms/ml lipopolysaccharide. Of the 24 individuals studied, spontaneous interleukin 1 secretion was detected from unstimulated macrophages in only 1 patient and 1 normal volunteer. We conclude that alveolar macrophages lavaged from the lungs of patients with inflammatory lung disease have an increased capacity to secrete interleukin 1 on in vitro stimulation with lipopolysaccharide. Possible mechanisms for this increase are discussed.
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PMID:Interleukin 1 secretion from human alveolar macrophages in lung disease. 348 3

We reviewed the clinical records and chest radiographs of all patients admitted to our institution between 1982 and 1984 who had pulmonary disease and who were later proved to have acquired immunodeficiency syndrome (AIDS) (95 patients). Diffuse parenchymal lung disease was the most common finding. These infiltrates were usually interstitial and caused by Pneumocystis carinii pneumonia or P. carinii combined with cytomegalovirus infection. Focal, multilobar, interstitial infiltrates were also often seen and usually caused by P. carinii or P. carinii and cytomegalovirus infections. Rarely, well-defined, multiple, interstitial nodules less than 10 mm in diameter were the only or predominant characteristic and were seen only in association with Mycobacterium tuberculosis or Cryptococcus neoformans infections or Kaposi sarcoma. Hilar or mediastinal adenopathy occurred in 17 of the 21 patients with M. tuberculosis or C. neoformans infections. In contrast, only 4% of patients with P. carinii infections presented with these findings. We also found that hilar or mediastinal adenopathy was not significantly associated with peripheral adenopathy. Lung cavitation, pleural effusion, or a normal chest radiograph was uncommon.
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PMID:Pulmonary manifestations of AIDS: review of 106 episodes. 348 55

Five cases of Pneumocystis carinii infection with evidence of lung tissue destruction that occurred in patients with the acquired immunodeficiency syndrome were reviewed. None of the patients had a history of cigarette smoking, but all five had either cavitarylike lesions in the lungs or had pneumothorax at the time of presentation to the hospital. All patients had P carinii identified in specimens obtained either from bronchial washings or from open-lung biopsy. In four of the five patients, no other pathogens were involved in the lungs, while the fifth patient had concomitant cytomegalovirus infection. Findings on chest roentgenograms included large thin-walled cavitarylike lesions, multiple cavitary lesions, or pneumothorax. These presentations of the infection have not been previously described, and the mechanisms for lung tissue damage are as yet unknown. Cavitary lung disease found on chest roentgenograms in patients should not exclude the diagnosis of P carinii pneumonia, and patients with the acquired immunodeficiency syndrome presenting with pneumothorax should have the possibility of P carinii infection included in the differential diagnosis.
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PMID:Evidence for destruction of lung tissues during Pneumocystis carinii infection. 349 47

After revising literature concerning Pneumocystis Carinii Pneumoniae (PCP), the authors undertook a close examination of the immunological system of the HIVab-positive patients that suffered opportunistic pneumopathy from PCP. Hundred-forty-three cases of HIVab-positive (mean age of 29), prevalently heroin drug-users, were studied. There were 13 AIDS, 26 ARC, 91 LAS cases and 13 patients with only Ab positivity for HIV. Four hundred chest radiographs were examined without previous knowledge of case histories. A small number of hilum and/or mediastinal lymphadenopathies was observed. Moreover, percentage increase in acute lung inflammatory diseases, mainly interstitial, was seen. These data were correlated to the worsening of the HIV infection and to the developing of LAS, ARC and AIDS. In a number of cases there was radiological evidence of progressed inflammatory episodes. The clinical pattern of PCP patients is dramatic and often fatal. Clinical-radiological cases with special reference to acute interstitial disease, caused by opportunistic agents, are presented.
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PMID:[Contribution of chest radiology to the diagnosis of HIV virus infection]. 350 Apr 88

A pleomorphic bacterium exhibiting both acid-fast rod forms and non-acid-fast coccal forms, and identified as Mycobacterium avium-intracellulare was cultured from a facial lesion diagnosed as immunoblastic sarcoma. The patient was a 36 year-old homosexual man who died of the acquired immune deficiency syndrome (AIDS). In addition, the patient had pre-existing cutaneous lesions of Kaposi's sarcoma (KS), and was treated for probable but never proven, Pneumocystis carinii pneumonia (PCP). Variably acid-fast coccoid forms, and extremely rare acid-fast rods were demonstrated within the microscopic sections of the immunoblastic sarcoma. Similar-staining coccoid forms were also observed within the microscopic sections of the pre-existing KS tumors, and within the lung biopsy material showing inflammation suggestive of PCP. These findings, along with previously reported findings of similar bacterial forms in vivo in other cases of KS and AIDS, again suggest that variably acid-fast bacteria may play a role in the development of malignant tumors and inflammatory lung disease, which frequently occur in homosexual men with AIDS.
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PMID:Mycobacterium avium-intracellulare infection and immunoblastic sarcoma in a fatal case of AIDS. 373 65

Bronchoalveolar lavage (BAL) cell populations were determined in 47 immunosuppressed patients during episodes of pulmonary disease. Thirty six patients had AIDS and 11 had conventional causes of immunosuppression. Pulmonary disease was due to a variety of infectious and noninfectious causes and was similar in both groups. In the AIDS patients, the mean BAL cell proportions were 64.2 +/- 3.7 percent alveolar macrophages (MACS), 28.7 +/- 3.4 percent lymphocytes, 3.5 +/- 1.8 percent polymorphonuclear cells (PMN) and 1.6 +/- 0.6 percent eosinophils (EOS). The non-AIDS group had similar findings in the BAL, with 59.3 +/- 8.3 percent MACS, 34.8 +/- 7.2 percent lymphocytes, 5.5 +/- 1.7 percent PMN and 0.4 +/- 0.2 percent EOS. The most striking finding in each group was a significant increase in both the proportion and absolute number of lymphocytes compared to controls. This was in marked contrast to the peripheral blood findings of lymphopenia. There was no characteristic cell profile diagnostic of any specific pulmonary disease. There was also no direct relationship of the cells present to respiratory symptoms, roentgenographic abnormalities or survival from pulmonary disease. This study demonstrates that although there was wide individual variation in lavage findings, a local pulmonary inflammatory reaction consisting predominantly of lymphocytes occurs in the immunosuppressed host during episodes of lung disease. The significance of this lymphocyte alveolitis and the complex host pathogen interaction responsible for determining the cell populations present in the lungs of these patients requires further study.
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PMID:Pulmonary cell populations in the immunosuppressed patient. Bronchoalveolar lavage findings during episodes of pneumonitis. 402 44

AIDS is known in Central African Republic since 1983: 64 recognized cases have been registered. AIDS is of endemic aspect presenting the main following signs: lost of weight (100%), degeneration of the health status (80%), lymphadenopathy (46%), pneumopathy (44%), diarrhea (40%), candidiasis (21%), Kaposi's disease (16%), purpura (8%), pruritus (8%), Cutaneous anergy to tuberculin or to the 7 antigens (Merieux test) is constant. LAV serology was positive in 61 cases. The number of helper T. cells is less than 400/mm3, and OKT4/OKT8 ratio is less than 0.50. The concerned population is heterosexual with a sexual hyperactivity.
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PMID:[Clinical aspects of AIDS in the Central African Republic]. 408 25

The effectiveness of fiberoptic bronchoscopy with the addition of bronchoalveolar lavage (BAL) was evaluated in 72 patients with the acquired immune deficiency syndrome (AIDS) and parenchymal pulmonary disease. The diagnostic yield varied for different pathogens and was 94% (45/48 cases) for Pneumocystis carinii, 67% (14/21 cases) for cytomegalovirus, and 62% (8/13 cases) for Mycobacterium avium intracellulare. Of the 11 cases of documented Kaposi's sarcoma in the lung parenchyma, none were diagnosed from bronchoscopy, although characteristic endobronchial lesions were seen in 6 cases. Overall, the yield of bronchoscopy for all pathogens was 65%. Both transbronchial biopsy and BAL had high independent yields (88 and 85%, respectively) for diagnosing P. carinii pneumonia but combining the procedures gave the best yield. Cytomegalovirus was most often diagnosed from examination and culture of the BAL. Recovery of Mycobacterium avium intracellulare was highest with culture of both washings and lavage. Neither granuloma nor organisms were seen on examination of histologic specimens. Bronchoscopy with BAL was well tolerated with few complications even in 5 patients with thrombocytopenia and 10 patients requiring mechanical ventilation. Sixteen patients (22%) had an increase in temperature after the procedure without hypotension or sepsis and 1 patient (1.5%) had a moderate pulmonary hemorrhage after transbronchial biopsy. Fiberoptic bronchoscopy with BAL is a safe procedure with a high diagnostic yield in AIDS patient with lung disease.
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PMID:Diagnosis of pulmonary disease in acquired immune deficiency syndrome (AIDS). Role of bronchoscopy and bronchoalveolar lavage. 609 9


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